| NPI | 1932656337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP JOSEPH CITEK Authorized Official 805-909-0612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A47889) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A44775) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A47889) | |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2016-09-02 |